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We aimed to determine the variations in the prevalence of childhood anemia according to the ethnic group before and during the COVID-19 pandemic in Peru. Secondary analysis of the Demographic and Family Health Survey during 2016–2021. The outcome variable was anemia, and the exposure variable was maternal ethnicity. Also, we included sociodemographic and clinical confounding variables. We constructed generalized linear models of the Poisson family with a logarithmic link function. We evaluated 85,905 records; 30.34% had anemia, 50.83% were mestizo, 25.98% were Quechua, and 2% were Aymara. Compared with mestizos, Quechua children (PR: 1.11; 95% CI: 1.07–1.15; p < 0.001), Aymara (PR: 1.35; 95% CI: 1.27–1.44; p < 0.001), natives of the Amazon (PR: 1.20; 95% CI: 1.12–1.28; p < 0.001) and those who belonged to other indigenous peoples (PR: 1.29; 95% CI: 1.05–1.57; p = 0.013) had a higher prevalence of childhood anemia. On the contrary, compared to mestizos, white children had a lower prevalence of anemia (PR: 0.93; 95% CI: 0.89–0.99; p = 0.019). During the COVID-19 pandemic, compared to mestizos, only Quechua (PR: 1.15; 95% CI: 1.08–1.23; p < 0.001) and Aymara (PR: 1.38; 95% CI: 1.23–1.55; p < 0.001) had a higher prevalence of childhood anemia. Except for Afro-descendants, children from 6 to 59 months of age who belong to an ethnic minority had a higher probability of having childhood anemia than mestizos. However, only Quechua and Aymara children had higher odds of anemia during the COVID-19 pandemic than mestizos. [ABSTRACT FROM AUTHOR]

Background: Syphilis is among the most common sexually transmitted infections worldwide. When it occurs during pregnancy, it can seriously affect the fetus and newborn's health. The scarcity of studies on maternal and congenital syphilis in Indigenous Peoples remains an obstacle to its control in these populations. This study aimed to explore the breadth of the literature, map updated evidence, and identify knowledge gaps on maternal and congenital syphilis in Indigenous Peoples worldwide. Methods: We conducted a Scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses - Extension for Scoping Reviews. In March 2021, we collected data through a priority search on PubMed, Web of Science, Embase, and SciELO. Results: The strategy yielded 24 studies for analysis. Data in the articles were collected from 1989 to 2020, half from 2015 onwards. Studies were in Oceania and the Americas, mainly in South America (66.7%), particularly in Brazil (50.0%). The topics assessed were Data quality related to maternal and congenital syphilis (20.8%); Diagnosis, provision, access, and use of health services (62.5%); Disease frequency and health inequities (54.2%); Determinants of maternal syphilis and congenital syphilis (20.8%); and Outcomes of maternal and congenital syphilis in the fetus (20.8%). The results show that the available literature on maternal and congenital syphilis is sparse and concentrated in some geographic areas; the frequency of these diseases in Indigenous Peoples varies but is generally higher than in the non-indigenous counterparts; the quality of surveillance data and health information systems is poor; multiple healthcare barriers exist; and the diversity of terms to identify Indigenous Peoples is a challenge to mapping scientific outputs on Indigenous Peoples' health. Conclusions: Maternal and congenital syphilis in Indigenous Peoples is a double-neglected condition and research in this area should be given the priority and encouragement it deserves globally. Reliable data and improving access to health care are needed to reduce the burden of syphilis and correctly inform policies and health services response to mitigate ethnic-racial inequalities in maternal and congenital syphilis. [ABSTRACT FROM AUTHOR]

Ethnopharmacological Relevance: The Asháninka people are the largest Peruvian Amazonian group, yet the knowledge of their medicinal plants is scarce. This study on Asháninka herbal medicine offers an insight into the Asháninka aetiological system, resting within the wider ontological framework of animism, and cultural expressions of the biomedical understanding of illnesses., Aim of the Study: To document wild-grown (non-cultivated) plant species in current use by the Asháninka people and look closer at their herbal practices during the Covid-19 pandemic. The study examines whether the knowledge and use of medicinal plants is gendered in this society. It also compares the findings with available literature concerning the Arawakan groups from Peruvian Amazonia., Material and Methods: The fieldwork was conducted in 13 native communities of the Asháninka people along the Tambo River (Selva Central), Peru, between 2016 and 2018 and in 2022. The main field technique were guided walks in the forest with 27 female and 28 male participants, during which voucher specimens were collected and relevant information was recorded. Semi-structured interviews were performed with specialists in Asháninka traditional medicine and with lay Asháninka people to better understand Asháninka illness aetiologies. The analysis of medicinal plants included medicinal categories and uses, modes of preparations, the frequency of use and the knowledge about the plants between the genders. It also presents and discusses detailed testimonies of herbal remedies during the Covid-19 pandemic. The list of recorded plants was compared with ethnobotanical studies of other Arawakan groups from Peruvian Amazonia., Results: Altogether, 169 wild-grown medicinal plant species were documented. Our findings highlight the importance of the Piperaceae and Acanthaceae botanical families in the Asháninka pharmacopoeia. The plants were used for 23 medicinal categories, of which dermatological disorders, digestive problems and venomous bites were the most prevalent. Over 70% of recorded plants were commonly and moderately known by the study participants. More exclusive species were found among the men than women; however, 64 % of all recorded plants were known to both genders. Sixty-one percent of recorded plants were not mentioned by any other study of medicinal plants among other Arawakan groups in Peruvian Amazonia. During the Covid-19 pandemic, nobody in the native communities at the Tambo River died directly due to the virus, which was attributed, amongst others, to effective and culturally-appropriate prophylaxis and treatments with medicinal plants., Conclusion: To this day, the Asháninka people at the Tambo River conserve the knowledge and practices related to medicinal plants which meet the daily needs of dwelling in subtropical forest; these are deeply rooted in animistic ontology, with the emphasis on spirit predation and retaliation. And yet, numerous applications of plants are compatible with the biomedical notion of illness and symptoms. Plant knowledge is shared between the genders, although specific plants exist for men and women, which are related to their gendered social and family roles. Some overlap and consensus exists with other studies regarding medicinal uses, which reflects the rich and diverse knowledge of medicinal plants among the Arawakan groups in Peruvian Amazonia, and this deserves further study., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Part of this text resulted in a lecture presented at the opening of the 20th National Science and Technology Week of the Oswaldo Cruz Foundation in October 2023. It is the reflection of an Indigenous historian on her professional trajectory, considering the racism in force in the scientific community and the paths that the Indigenous knowledge rivers have traveled to demarcate writing as a field for securing the rights guaranteed in the 1988 Federal Constitution, constituting a space of resistance for the continuity of the Brazilian Indigenous peoples' plural existences.

In recent decades, affirmative actions have enabled Indigenous people to access medical school, historically occupied by white people with high family incomes. This research analyzed experiences of otherness by Indigenous people in federal medical schools. This qualitative, exploratory study adopted interviews and conversation circles, with the participation of 40 students from 15 courses. We established four categories of analysis: encounter between "strangers" and the medical school; differences and inequalities; relationships with students and teachers; and conflicts and transformations. We noticed that medical schools are unwelcoming to Indigenous people, with racism, intolerance, and tutelage, when their differences become inequalities, resulting from structural processes in these Brazilian institutions. The Indigenous presence in medical courses reveals social inequalities, causes conflicts, and initial transformations, pointing out paths for plurality and social justice, and possibilities for medical education with visibility and actions for the health of Indigenous peoples.

The present study aimed to assess the anthropometric nutrition status and physical growth of Terena Indigenous children living in an urban zone of the city of Campo Grande, Mato Grosso do Sul, Brazil, in their first year of life. Children who were born between June 2017 and July 2018 (n = 42) participated in the study. In total, 4.8% of the children presented a low height for age (H/A) in the 12th month of life. According to body mass index (BMI) for age, overweight affected 15.0% of the individuals belonging to the female sex at the age of 12 months, and obesity was observed in 4.8% of the children belonging to both sexes at this same age. Terena Indigenous children's length curve failed to reach the median value recorded for the reference population. Weight and body mass index curves for age, mainly among individuals belonging to the female sex, were often above the reference median value. The Terena growth curves recorded an average linear growth of lower than expected and a weight gain of higher than the reference median. This profile is compatible with the persistence of unfavorable conditions for children's growth and nutrition, as well as with an accelerated process of food and nutritional transition, where the racial dimension of health inequities cannot be disregarded.

This study aimed to evaluate the body composition of the Khisêdjê, an Indigenous people residing in the Xingu Indigenous Territory, and compare it to the results obtained by anthropometry. One hundred seventy-nine individuals aged above 20 of both genders were included. The nutritional status was classified per the cutoff proposed by the WHO (1995). The body composition was identified using measures derived directly from a bioelectrical impedance device (resistance - R, reactance - Xc, and phase angle - PA). Data were analyzed using the Student t-test, chi-square, Pearson correlation, and analysis of variance, and 57% of the sample was male. The mean age of the population was 37.5 years, and 48% of subjects had some overweight level (BMI ≥ 25,0 kg/m2). We identified a positive correlation between BMI with waist (WC) and arm (AC) circumference, and PA measurements, and an inverse correlation between BMI and R and Xc measurements. R and Xc mean values decreased with increasing BMI. In contrast, mean PA increased with greater weight. The results suggest that being overweight among the Khisêdjê Indigenous people was associated with higher muscle mass amounts.

Primarily since the early 2000s, Indigenous peoples in Brazil have become beneficiaries of social security and income transfer policies, such as the program known as Bolsa Família (Family Allowance). Few field studies have evaluated the magnitude and significance of monetarization in Indigenous social lives and economies. To this end, between 2019 and 2020, the present work conducted an ethnographic study and survey in two villages of the Rikbaktsa people in the Brazilian Amazon. The quantitative results showed the social dissemination of money from governmental Programs and other activities, producing marked income classes. Important transactions were not captured, considered as "helps" that could not be denied by those with a given amount of money. Like an Indigenous "Bolsa Família", hybrid resources were redistributed in a heated-up village market, counteracting socioeconomic differences and unequal conditions. The discussion takes place in a globally unfavorable sociopolitical context that exacerbates historical inequalities expressed in the living and health conditions of Indigenous peoples. This research contributes to the production of data and the proposal of culturally sensitive methodologies to estimate and enable the governance of public policies for/by Indigenous people, which are recommended to reverse these inequities.

This study analyzes the implementation of the Indigenous Health Policy, focusing on the care practices of health teams of the Indigenous Health Care Subsystem in the Upper Solimões River in the Amazon region. Using ethnography as a methodological resource, the dynamics among participants, discourses, and power in the implementation of the policy are investigated, revealing a complex interconnection between practices and other contextual realities. Three phenomena emerge as critical influences on care practices: the medical-care model, the sanitation model, and the culture of performance. The medical-care and sanitation models are perpetuated. The culture of performance introduces a control paradigm based on quantitative indicators and pre-defined goals, affecting professional identity, social interactions, and the effectiveness of actions. On the margins of the institution, other daily practices are induced by temporal needs, subjective feelings, and local networks of power, thus challenging social structures and conventions. The Indigenous Health Policy was reformulated by practices influenced by old policies and was remodeled by techniques induced by bureaucracy, distancing itself from its ideological agenda.

Brazil, one of the world's largest agricultural producers and consumers of pesticides, has expanded its agricultural area in the southern region of Mato Grosso do Sul, intensifying environmental contamination and increasing the vulnerability of indigenous populations. This research assessed the presence of pesticides in the waters of two indigenous communities in MS, Retomada Guyraroká and Aldeia Jaguapiru. Between 2021 and 2022, three sampling campaigns of surface, supply, and rainwater were conducted, considering the agricultural calendar. The study followed the LARP/UFSM protocol. In total of 22 active ingredients (AIs) were found, among these, 41% cause serious health effects, and 68% are banned in the European Union. Fipronil, 2,4-D, Atrazine are the among the most frequent IA found. Results show that these communities are exposed to pesticides, violating their rights to health and food sovereignty.

In this interview, Weibe Tapeba, secretary of Indigenous Health at the Ministry of Health in the Lula Government, discusses the process of reorganizing the Secretariat of Indigenous Health (SESAI) and Indigenous protagonism in the new administration. Among the points highlighted by the interviewee are the assessment of the Indigenous health scenario within the current political context of the Ministry of Health, dialogues with Indigenous movement organizations, as well as collaboration with research and educational institutions. The interview highlights the importance of developing strategies aimed at restructuring SESAI and improving Indigenous health public policy in Brazil through extensive coordination, involving planning, management, funding, and Indigenous social participation with Social Control. The secretary emphasizes the need for political cooperation within the federal government to promote the development of a policy of "comprehensive care in Indigenous territories," arguing that the concept of primary health care needs to be expanded to ensure that the principles of SUS are effectively guaranteed to Indigenous peoples in Brazil.

The Indigenous Health Conferences (IHC) have been the political spaces for expressing and consolidating ideas and proposals. However, in 1993, the "First Indigenous Health Forum" was held a few months before the second IHC. With a historical approach, this paper aimed to understand the organization and impacts of this Forum in the construction of Brazilian Indigenous Health policies during the 1990s. We analyzed an unpublished set of documents organized as a Dossier by Dr. István Varga and deposited in the University of São Paulo's library. We discuss that a strong connection with the First Indigenous Health Forum was established between the first and second IHC. The argumentative structures and proposals formulated in the First Indigenous Health Forum were reinforced during the subsequent events culminating in the Second IHC.

This case study analyzed arrangements and strategies of the network actors in the Special Indigenous Sanitary District (DSEI) Pernambuco's territory to guarantee the right to health of Indigenous populations during the COVID-19 pandemic. This work was carried out through document analysis, workshops, and field research. The Contingency Plan for COVID-19 in Indigenous Peoples of DSEI Pernambuco included surveillance actions, laboratory and pharmaceutical assistance, communication, and management. With the modeling of this document, it was noticed that actions aimed at local specificities were not integrated: in its initial design, at the national level, the voice of Indigenous leaders was not heard when formulating this plan. By contrast, the actions of these leaders and their mobilization to mitigate the effects of the pandemic on the Indigenous population stands out. Contextual factors were cited as facilitators and obstacles to the plan's implementation; the local sociotechnical network mapping also made it possible to identify strategic actors and actants in the face of the COVID-19 pandemic and verify their performance or ineffectiveness. The findings of this study reflect recurrent problems in the organization of the Indigenous health system.

This article discusses the meanings of differentiated health care guideline given by health professionals from the Indigenous Health Multidisciplinary Team (EMSI) who work at the Alto Rio Negro Special Indigenous Health District (DSEI-ARN). This exploratory, descriptive, analytical, and qualitative study conducted 15 semi-structured interviews with professionals from the Indigenous Health Multidisciplinary Teams of the DSEI-ARN, which were submitted to content analysis. The four meaning cores identified from the analyses were: Differentiated care as a way of providing primary care in the territory; Actions conducted under the population's cultural differences; Self-care, traditional medicine, and the construction of therapeutic itineraries; and Professionals' challenges and difficulties in addressing traditional indigenous health care. In the professionals' perspective, differentiated health care is linked to the conditions for working in this primary care type. For their performance, they refer to the need to respect the cultural differences of the Indigenous population. Professionals recognize the use and effectiveness of Indigenous practices, knowledge, and regional specificities.

This study examines the relationship between ethnic endogamy and socioeconomic status (SES) within the socioeconomically divergent Jewish and Native-Chilean Mapuche communities of Santiago, Chile. By leveraging the Hispanic naming convention to analyze dual ethnic surnames, we trace endogamy patterns across comprehensive datasets that go back to 1884 up to the present. Our quantile regression analysis reveals that individuals from the lower SES brackets of the Jewish community and the higher brackets of the Mapuche community are more likely to have mixed ethnic backgrounds. This finding shows a nuanced interplay between socioeconomic standing and marital choices, suggesting that these factors significantly influence the persistence and transformation of SES within minority groups. The study introduces the Ecological Model of Ethnic Disaffiliation, providing a theoretical framework that explains how socioeconomic outliers within ethnic groups could lead to a narrowing of their socioeconomic range over generations., (© 2024 The Author(s). The British Journal of Sociology published by John Wiley & Sons Ltd on behalf of London School of Economics and Political Science.)

Background: The increase in population longevity often occurs in contexts of inequity and relative poverty, accompanied by economic deterioration. This becomes a social determinant that has a direct impact on food security. This phenomenon particularly affects certain groups and territories, although there is still a lack of disaggregated references. Intersections between factors such as being a rural inhabitant, Indigenous, woman, or elderly person are observed in relation to food security, which forces us to pay greater attention to gaps that have remained invisible for years., Objective: The objective of this study is to analyze the main factors that affect the food security of Mapuche men and women over 60 years of age living in the rural area of Temuco, Chile., Method: Qualitative, descriptive, and interpretative research was carried out, observing the process from the interpretative symbolic paradigm and the complexity approach., Results: The data are made up of the discourses of these subjects, whose analysis allowed for the identification of results. These results show that producing their own food enables rural Mapuche elders to achieve food security. The cultural food heritage preserved by Mapuche elders, especially women, acts as a facilitating factor, as do community spaces that reinforce their culture. Among the obstacles to food security are migration to the city for work, pathological aging, and the limited production of culturally healthy foods (affected by environmental problems, cultural changes, the destabilization of group identity, and public policies that are incongruent with the territorial worldview)., Conclusions: While rural Mapuche elders retain valuable practices for their food security, inadequate policies, migration and environmental degradation present significant challenges.

Background: Peru is a low-endemic transmission area for malaria, where the majority (84%) of incident malaria cases are localized to the department of Loreto, which is composed of several geographically isolated rural communities. Recent intervention efforts targeting at-risk Indigenous populations that live in riverine communities in Loreto place emphasis on preventive behaviours to decrease transmission. However, malaria related behaviour change is often dependent upon local knowledge, beliefs, and practices, especially in areas where malaria is viewed an embedded and unavoidable aspect of life., Methods: This exploratory case study used semi-structured interviews conducted in Spanish between February and March of 2019 to examine the knowledge, attitudes, and practices related to malaria prevention among the Indigenous Maijuna people of Sucusari, Loreto, Peru. Participants who consented were also administered a rapid diagnostic test (RDT) upon the time of interview., Results: A total of 33 community members were interviewed, and 31 were tested via malaria rapid diagnostic tests, with RDT filter paper subsequently tested using PCR. All test results were negative for malaria. Themes that emerged included: varying knowledge of methods to prevent malaria, reports of observed changes in malaria incidence over time, confusion surrounding malaria transmission, treatment-seeking as a common behaviour, the belief that medications are effective, and the acceptance of bed nets which were viewed as a lifestyle norm., Conclusion: These shared narratives should be used as a foundation for further studies and health interventions among communities in the Peruvian Amazon with limited access to health services where culturally resonant, community-based health programming is essential to improving health. Takeaways regarding confusion surrounding malaria transmission should also be considered., (© 2024. The Author(s).)

The Cerrado is home to a diversity of traditional communities, among which indigenous and quilombola peoples stand out. The Karajá are one of the ethnic groups in this biome, with a rich history and culture that goes back centuries. They mainly inhabit the regions of the Araguaia and Javaés rivers, occupying lands in the states of Goiás, Mato Grosso, Pará and Tocantins. Considering the importance of studies on ethnomycological knowledge in indigenous communities for preserving culture and the environment, especially in relation to fungi, our objective was to investigate the ethnomycological relationships of the Karajá indigenous people who inhabit Bananal Island, located in Tocantins. Data were collected from applying a semi-structured questionnaire and interviews with 140 people who compose the Macaúba (39%), Fontoura (31%) and Santa Isabel do Morro (30%) communities; they had an average age of 33.9 years, and 62% are male. We observed that the Karajá people recognize the fungi of the environment in which they live, showing a clearer perception of typical morphological groups, such as mushrooms and bracket fungi (wood ears). Although fungi are not used as a component of their diet, the Karajá recognize that some species may have this potential. Furthermore, they use fungi as adornments and decorations in festivities in a playful way, and occasionally for medicinal purposes. Therefore, we can state that this ethnic group does not have a total aversion to fungi, being considered partially mycophilic. This study is a pioneer among Cerrado indigenous people, and reinforces the need to expand research to other communities in different regions in order to expand ethnomycological knowledge among different ethnicities. These investigations could contribute to both an appreciation and conservation of the traditions and knowledge of original Brazilian people, as well as the biodiversity in which they are inserted., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Reis et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

This article aims to systematize and analyze, from a historical perspective, the discussions that permeated the topic of indigenous health in interface with the demography of these populations, based on the political dimension that the quantification of indigenous peoples assumed during the military dictatorship in Brazil. Covering an extensive period that extends from the establishment of the Indian Protection Service in 1910 until the end of the 1980s, this article offers a comprehensive view of the topic. The analysis focuses primarily on the 1970s, highlighting the actors involved in this debate: indigenous leaders, indigenists, academics, health professionals, and missionaries.

Industrialized environments, despite benefits such as higher levels of formal education and lower rates of infections, can also have pernicious impacts upon brain atrophy. Partly for this reason, comparing age-related brain volume trajectories between industrialized and non-industrialized populations can help to suggest lifestyle correlates of brain health. The Tsimane, indigenous to the Bolivian Amazon, derive their subsistence from foraging and horticulture and are physically active. The Moseten, a mixed-ethnicity farming population, are physically active but less than the Tsimane. Within both populations (N = 1024; age range = 46-83), we calculated regional brain volumes from computed tomography and compared their cross-sectional trends with age to those of UK Biobank (UKBB) participants (N = 19,973; same age range). Surprisingly among Tsimane and Moseten (T/M) males, some parietal and occipital structures mediating visuospatial abilities exhibit small but significant increases in regional volume with age. UKBB males exhibit a steeper negative trend of regional volume with age in frontal and temporal structures compared to T/M males. However, T/M females exhibit significantly steeper rates of brain volume decrease with age compared to UKBB females, particularly for some cerebro-cortical structures (e.g., left subparietal cortex). Across the three populations, observed trends exhibit no interhemispheric asymmetry. In conclusion, the age-related rate of regional brain volume change may differ by lifestyle and sex. The lack of brain volume reduction with age is not known to exist in other human population, highlighting the putative role of lifestyle in constraining regional brain atrophy and promoting elements of non-industrialized lifestyle like higher physical activity., (© 2024. The Author(s).)

Background: Indigenous knowledge and responses were implemented during the COVID-19 pandemic to protect health, showcasing how Indigenous communities participation in health systems could be a pathway to increase resilience to emergent hazards like climate change. This study aimed to inform efforts to enhance climate change resilience in a health context by: (1) examining if and how adaptation to climate change is taking place within health systems in the Peruvian Amazon, (2) understanding how Indigenous communities and leaders' responses to climatic hazards are being articulated within the official health system and (3) to provide recommendations to increase the climate change resilience of Amazon health systems., Methods: This study was conducted among two Peruvian Amazon healthcare networks in Junin and Loreto regions. A mixed methodology design was performed using a cross-sectional survey (13 healthcare facilities), semistructured interviews (27 official health system participants and 17 Indigenous participants) and two in-person workshops to validate and select key priorities (32 participants). We used a climate-resilient health system framework linked to the WHO health systems building blocks., Results: Indigenous and official health systems in the Peruvian Amazon are adapting to climate change. Indigenous responses included the use of Indigenous knowledge on weather variability, vegetal medicine to manage health risks and networks to share food and resources. Official health responses included strategies for climate change and response platforms that acted mainly after the occurrence of climate hazards. Key pathways to articulate Indigenous and official health systems encompass incorporating Indigenous representations in climate and health governance, training the health work force, improving service delivery and access, strengthening the evidence to support Indigenous responses and increasing the budget for climate emergency responses., Conclusions: Key resilience pathways call for a broader paradigm shift in health systems that recognises Indigenous resilience as valuable for health adaptation, moves towards a more participatory health system and broadens the vision of health as a dimension inherently tied to the environment., Competing Interests: Competing interests: CZ-C declares that her salary was covered partially with funds of this study. All other authors declare no competing interests., (© World Health Organization 2024. Licensee BMJ.)

The Yanomami are one of the oldest indigenous tribes in the Amazon and are direct descendants of the first people to colonize South America 12,000 years ago. They are located on the border between Venezuela and Brazil, with the Venezuelan side remaining uncontacted. While they maintain a hunter-gatherer society, they are currently experiencing contact with urbanized populations in Brazil. The human gut microbiota of traditional communities has become the subject of recent studies due to the Westernization of their diet and the introduction of antibiotics and other chemicals, which have affected microbial diversity in indigenous populations, thereby threatening their existence. In this study, we preliminarily characterized the diversity of the gut microbiota of the Yanomami, a hunter-gatherer society from the Amazon, experiencing contact with urbanized populations. Similarly, we compared their diversity with the population in Manaus, Amazonas. A metabarcoding approach of the 16 S rRNA gene was carried out on fecal samples. Differences were found between the two populations, particularly regarding the abundance of genera (e.g., Prevotella and Bacteroides) and the higher values of the phyla Bacteroidetes over Firmicutes, which were significant only in the Yanomami. Some bacteria were found exclusively in the Yanomami (Treponema and Succinivibrio). However, diversity was statistically equal between them. In conclusion, the composition of the Yanomami gut microbiota still maintains the profile characteristic of a community with a traditional lifestyle. However, our results suggest an underlying Westernization process of the Yanomami microbiota when compared with that of Manaus, which must be carefully monitored by authorities, as the loss of diversity can be a sign of growing danger to the health of the Yanomami., (© 2024. The Author(s).)

Theories of early development have emphasized the power of caregivers as active agents in infant socialization and learning. However, there is variability, across communities, in the tendency of caregivers to engage with their infants directly. This raises the possibility that infants and children in some communities spend more time engaged in solitary activities than in dyadic or triadic interactions. Here, we focus on one such community (indigenous Wichi living in Argentina's Chaco Forest) to test this possibility. We examine naturally occurring attentional activity involving the mother and child among the Wichi and among Eurodescendant Spanish-speaking families living in Argentina. We engaged 16 families-8 Wichi and 8 Eurodescendant-in an observational study of interactions between caregivers and their 1- to 2-year-olds. A mixed-analytic approach revealed no differences between communities in the proportion of time infants spent alone, or in mother-child interaction. What does differ, however, is how mothers engage in these interactions: Wichi mothers spend a greater proportion of their time observing their infants than do Eurodescendant mothers. Moreover, when infants in both groups are alone, they focus their 'solitary' activities differently: Wichi infants engaged primarily in observation alone, whereas Eurodescendant infants were more focused on the object. Finally, all mother-child pairs engaged in dyadic and triadic (object-infant-caregiver) patterns of attention, but the triadic patterns differed considerably between cultures: Among Wichi, mothers actively "watched" infants as they engaged with objects, whereas Eurodescendant mothers actively engaged with their infants in joint attentional episodes. This work illustrates how attention and socialization, key mechanisms of early development, are culturally organized. A video abstract of this article can be viewed at https://www.youtube.com/watch?v=SwsOCLXubKQ. RESEARCH HIGHLIGHTS: Longitudinal, observational investigation of mother-infant interaction in two distinct Argentine cultural groups (Wichi and Eurodescendants) reveals both commonalities and clear community-based differences in interactions between mothers and their 1- to 2-year-olds. Wichi mother-infant dyads engaged primarily in visual observation of one another, but their Eurodescendant counterparts tended to engage in more verbal or physical interaction. We identify a new form of triadic interaction-lateral joint attention-among the Wichi dyads. This work underscores that attention and socialization, key mechanisms of early development, are culturally organized., (© 2024 John Wiley & Sons Ltd.)

Aim: The present study sought to investigate dental caries experience and its association with sociodemographic, postnatal and breastfeeding variables in children in the agerange from 6 to 71 months of age, in the Xingu Indigenous Park, Mato Grosso, Brazil. Methods: This was an analytical cross-sectional study that used secondary data pertaining to 402 indigenous children of the Low, Middle and Eastern Xingu regions, who participated in the Oral Health Epidemiological Survey in 2013. The dependent variable was dental caries, dichotomized by the median (dmf-t≤1 and dmf-t>1). The data of independent variables were obtained by means of instruments of the Local Health Information System of the Xingu Indigenous Special Sanitary District (DSEI). Raw analyses were performed to test the association of the independent variables with the dependent variable. The variables were tested in the multiple logistic regression model. Results: The mean value of the dmf-t index was 2.60 and the prevalence of affected children was 51%. In the multiple analysis, only children older than 36 months (OR: 6.64; CI95%: 4.11 to 10.73) and those that were breastfed for a longer period of time (OR: 1.88; CI95%: 1.16 to 3.02) showed significant association with the dmf-t>1 index. Conclusion: Childhood dental caries among indigenous children was associated with age and breastfeeding prolonged for over 26 months, therefore, pointing out the need to offer dental follow-up care at earlier ages.

Breast cancer health disparities are linked to clinical-pathological determinants, socioeconomic inequities, and biological factors such as genetic ancestry. These factors collectively interact in complex ways, influencing disease behavior, especially among highly admixed populations like Colombians. In this study, we assessed contributing factors to breast cancer health disparities according to genetic ancestry in Colombian patients from a national cancer reference center. We collected non-tumoral paraffin embedded (FFPE) blocks from 361 women diagnosed with breast cancer at the National Cancer Institute (NCI) to estimate genetic ancestry using a 106-ancestry informative marker (AIM) panel. Differences in European, Indigenous American (IA) and African ancestry fractions were analyzed according to potential sources of breast cancer health disparities, like etiology, tumor-biology, treatment administration, and socioeconomic-related factors using a Kruskal-Wallis test. Our analysis revealed a significantly higher IA ancestry among overweight patients with larger tumors and those covered by a subsidized health insurance. Conversely, we found a significantly higher European ancestry among patients with smaller tumors, residing in middle-income households, and affiliated to the contributory health regime, whereas a higher median of African ancestry was observed among patients with either a clinical, pathological, or stable response to neoadjuvant treatment. Altogether, our results suggest that the genetic legacy among Colombian patients, measured as genetic ancestry fractions, may be reflected in many of the clinical-pathological variables and socioeconomic factors that end up contributing to health disparities for this disease., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Rey-Vargas et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The phenomenon of world aging is not foreign to indigenous communities. In the last few years, research about these communities around the world has increased, but aging in indigenous towns still has not been studied widely. The purpose of this research is to interpret the meaning of old age in two indigenous communities from the Colombian Andean-Amazon region (the Inga and Kamëntsa) to reinforce the relevance of the local sociocultural context within the configuration of the meaning of old age and to emphasize the importance of considering particular regional characteristics for the design of policies and interventions aiming to recognize and integrate indigenous populations. This is a qualitative study with an interactionism-symbolism approach. In total, six indigenous people older than 60 years from two ancestral communities from the Colombian Andean-Amazon region participated in the in-depth interviews. Data analysis was carried out in three moments: discovery, coding, and relativization of the information. The results show that old age means wisdom, "I am wise," which is supported in the cosmology and the trajectory of life, reinforces the identity and autonomy, and allows them to be agents in the dynamics of their communities from the "I do," in other words, their roles as builders of the family-society and as guards of ancestral knowledge. The loss of this knowledge and the elements that it is composed of uproot them and put them at risk of disappearing as individuals and as a collective. In conclusion, the meaning of old age in these communities is not centered on a determinate age; you are not old, you are wise, and as such, they play a central role in their communities. Moreover, wisdom is built in parallel with their cosmology and assigns them the task of safekeeping ancestral knowledge. In order to do this, they use oral tradition as a tool, words that are born in their territories, travel in a nonlinear timeline, and get strengthened by the community while also protecting it and building it. Knowing what aging means for Indigenous communities can facilitate to the development of policies and initiatives and to provide culturally appropriate and effective programs., (© 2024. The Author(s).)

In January 2021, oxygen supplies in the Amazon region's largest city were allowed to run out at the peak of the second wave of the COVID-19 epidemic, shocking the world as hospital patients expired for lack of this basic medical resource in Manaus, which during the first COVID-19 wave had become the world's first city to bury its dead in mass graves. Brazil's authorities used this tragedy to further a political agenda that implies enormous environmental and human-rights consequences. Transport of oxygen was used to promote building a road that, together with its planned side roads, would give deforesters access to much of what remains of Brazil's Amazon Forest. Here, we demonstrate that the logistical strategy adopted by the Jair Bolsonaro administration's Ministries of Health and Infrastructure to bring oxygen to Manaus was the worst possible choice, and the foreseeable delay in the arrival of oxygen cost hundreds of lives. Rather than sending trucks to carry oxygen on the nearly impassible Highway BR-319 during the rainy season, the most appropriate transport option was barges on the Madeira River. As oxygen supplies dwindled in Manaus, the families of wealthier COVID-19 victims scrambled to buy the few remaining cylinders at prices out of reach for those in poorer (and often ethnically distinct) economic strata. Ethnic health disparities are aggravated by both the direct consequences of the oxygen crisis and, on the longer term, by the consequences of the highway project that political use of the crisis materially advanced., (© 2023. W. Montague Cobb-NMA Health Institute.)

Argentina has a heterogeneous prevalence of infections by intestinal parasites (IPs), with the north in the endemic area, especially for soil-transmitted helminths (STHs). We analyzed the spatial patterns of these infections in the city of Tartagal, Salta province, by an observational, correlational, and cross-sectional study in children and adolescents aged 1 to 15 years from native communities. One fecal sample per individual was collected to detect IPs using various diagnostic techniques: Telemann sedimentation, Baermann culture, and Kato-Katz. Moran's global and local indices were applied together with SaTScan to assess the spatial distribution, with a focus on cluster detection. The extreme gradient boosting (XGBoost) machine-learning model was used to predict the presence of IPs and their transmission pathways. Based on the analysis of 572 fecal samples, a prevalence of 78.3% was found. The most frequent parasite was Giardia lamblia (30.9%). High- and low-risk clusters were observed for most species, distributed in an east-west direction and polarized in two large foci, one near the city of Tartagal and the other in the km 6 community. Spatial XGBoost models were obtained based on distances with a minimum median accuracy of 0.69. Different spatial patterns reflecting the mechanisms of transmission were noted. The distribution of the majority of the parasites studied was aligned in a westerly direction close to the city, but the STH presence was higher in the km 6 community, toward the east. The purely spatial analysis provides a different and complementary overview for the detection of vulnerable hotspots and strategic intervention. Machine-learning models based on spatial variables explain a large percentage of the variability of the IPs.

Background: Strategies for the control of scabies should be adapted to local settings. Traditional communities in French Guiana have non-Western conceptions of disease and health., Objectives: The objectives for this study were to explore knowledge, attitudes and practices to identify potential factors associated with the failure of scabies treatment in these communities., Methods: Patients with a clinical diagnosis of scabies, seen at either the Cayenne Hospital or one of 13 health centres between 01 April 2021 and 31 August 2021, were included as participants, and were seen again after 6 weeks to check for persistence of lesions. Factors associated with treatment failure were looked for both at inclusion and at 6 weeks. Semi-structured interviews were conducted with a diversified subsample of participants., Results: In total, 164 participants were included in the quantitative component, and 21 were interviewed for the qualitative component. Declaring that the second treatment dose had been taken was associated with therapeutic success. Western treatments were not always affordable. Better adherence was observed with topical treatments than with oral ivermectin, whereas permethrin monotherapy was associated with failure. Scabies-associated stigma was high among Amerindians and Haitians but absent in Ndjuka Maroons. Participants reported environmental disinfection as being very complex., Conclusions: The treatment of scabies in traditional Guianan communities may vary depending on local perceptions of galenic formulations, disease-associated stigma and differences in access to health care. These factors should be taken into account when devising strategies for the control of scabies aimed at traditional communities living in remote areas, and migrant populations., (© 2023 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.)

This pilot study aimed to investigate genetic factors that may have contributed to the milder clinical outcomes of COVID-19 in Brazilian indigenous populations. 263 Indigenous from the Araweté, Kararaô, Parakanã, Xikrin do Bacajá, Kayapó and Munduruku peoples were analyzed, 55.2% women, ages ranging from 10 to 95 years (average 49.5 ± 20.7). Variants in genes involved in the entry of SARS-CoV-2 into the host cell (ACE1 rs1799752 I/D, ACE2 rs2285666 C/T, ACE2 rs73635825 A/G and TMPRSS2 rs123297605 C/T), were genotyped in indigenous peoples from the Brazilian Amazon, treated during the SARS-CoV-2 pandemic between 2020 and 2021. The distribution of genotypes did not show any association with the presence or absence of IgG antibodies. Additionally, the influence of genetic variations on the severity of the disease was not examined extensively because a significant number of indigenous individuals experienced the disease with either mild symptoms or no symptoms. It is worth noting that the frequencies of risk alleles were found to be lower in Indigenous populations compared to both continental populations and Brazilians. Indigenous Brazilian Amazon people exhibited an ethnic-specific genetic profile that may be associated with a milder disease, which could explain the unexpected response they demonstrated to COVID-19, being less impacted than Brazilians., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2023. Published by Elsevier B.V.)

Background: In Babitonga Bay, southern Brazil, records of yam consumption exist among shellmound builders from at least 4000 years ago. Shellmounds (sambaquis) are anthropogenic structures in the form of mounds with layers of shells associated with other faunal remains, as well as with charcoal, artefacts and burial. Larger sambaquis are considered to be funerary monuments. The indigenous Jê and Guarani people also lived in the region before the European invasion and cultivated yams. Currently, exotic and domesticated yams are cultivated in the region by farmers. Our aim is to describe the long-term history between the people and Dioscorea in the Babitonga Bay region based on its consumption and occurrence in shellmounds and swiddens., Methods: Surveys of Dioscorea spp. and host were carried out in the vegetation of shellmounds and in the surrounding area using visual detection through intensive searches in transects using the walking method. The survey of Dioscorea species used and cultivated in the precolonial, colonial and current periods was carried out based on the literature. In the present study, only Dioscorea trifida cultivations were recorded., Results: Dioscorea cayennensis, Dioscorea chondrocarpa, Dioscorea dodecaneura, Dioscorea laxiflora, Dioscorea olfersiana, and Dioscorea scabra, all recorded in associated vegetation of shellmounds, in different combinations of the species. In swiddens, D. trifida is most common, followed by Dioscorea alata and, to a lesser extent, Dioscorea bulbifera and D. cayennensis. Records of food use prevail, but they are used as medicinal plants. Yams are integrated on anthropogenic soils of shellmounds and in swiddens in monoculture systems or in intercropping with Zea mays or Colocasia esculenta. The presence of exotic food trees and D. cayennensis in some shellmounds indicates the influence of colonizers on the composition of the vegetation. In sambaquis, there are overlapping processes of construction of cultural niches by different human groups at different times., Conclusions: The sambaquis and the associated vegetation and swiddens form part of a domesticated landscape. The native species of Dioscorea recorded in shellmounds and surrounding vegetation do not depend on human action to perpetuate themselves in the environment. However, this does not rule out human influence in the past, but it does not indicate horticulture among the Sambaquianos. Greater investment in genetic, archaeobotanical and ethnobotanical research can contribute to a better understanding of the relationship between people and yams over thousands of years., (© 2024. The Author(s).)

Background: Although about 10% of the Latin American population is indigenous, ethnic differences in disability-free life expectancy (DFLE) and life expectancy with disability (DLE) are unknown., Objective: To estimate disability-free life expectancy and disabled life expectancy among Mapuche (the largest indigenous group) and non-indigenous older adults aged 60 years or more in Chile., Method: Disability was measured following a methodology that combines limitations of daily living, cognitive impairment and dependence previously validated in Chile. Finally, the DFLE was estimated using Sullivan's method combining life tables by ethnicity and disability proportions from the EDES survey designed for the study of ethnic differentials in health and longevity in Chile., Results: Non-Indigenous people have a higher total and Disability-free life expectancy compared to Mapuche people at all ages. While at age 60 a Mapuche expects to live 18.9 years, of which 9.4 are disability-free, a non-Indigenous expects to live 26.4 years, of which 14 are disability-free. In addition, although the length of life with disability increases with age for both populations, Mapuche who survive to age 80 or 90 expect to live 84% and 91% of their remaining life with disability, higher proportions compared to non-indigenous people (62.9% and 75%, respectively)., Conclusions: This is the first study addressing inequities in DFLE between the Mapuche and non-Indigenous population, reflected in lower total life expectancy, lower DFLE and higher DLE in Mapuche compared to the non-Indigenous population. Our results underscore the need for increased capacity to monitor mortality risks among older people, considering ethnic differences., (© 2024. The Author(s).)

Objective: To report on the experience of nurses from the Street Clinic in caring for the Indigenous Venezuelan population of the Warao ethnic group in Maceió/AL based on Madeleine Leininger's Transcultural Theory., Metodology: A descriptive study, of the experience report type, based on the care of the Warao Indigenous population in the light of Madeleine Leininger's Transcultural Theory, carried out during the year 2022., Results: Light technologies were used to form bonds and understand the cultural universe of the Warao people. The concepts of preservation, accommodation and cultural restructuring of care from Leininger's transcultural theory helped to elucidate the practice. Comprehensive care was offered in accordance with the programs recommended by the Ministry of Health, with transcultural care, including respect for refusal of care. The language barrier and health beliefs represented challenges in the context of singular care., Final Considerations: The experience of nurses from the Street Clinic in caring for the Indigenous population favored significant social interaction and expanded the possibilities for achieving comprehensive health care. The application of Transcultural Theory proved to be an effective and congruent device for health care.

The analysis of mitochondrial DNA (mtDNA) hypervariable region (HVR) sequence data from ancient human remains provides valuable insights into the genetic structure and population dynamics of ancient populations. mtDNA is particularly useful in studying ancient populations, because it is maternally inherited and has a higher mutation rate compared to nuclear DNA. To determine the genetic structure of three Colombian pre-Hispanic populations and compare them with current populations, we determined the haplotypes from human bone remains by sequencing several mitochondrial DNA segments. A wide variety of mitochondrial polymorphisms were obtained from 33 samples. Our results support a high population heterogeneity among pre-Hispanic populations in Colombia.